Ultrasonographic assessment of lipodystrophy in HIV-1-infected patients.
OBJECTIVE
We performed a cross-sectional study of physical changes in HIV-infected adults to evaluate the role of ultrasonography for the diagnosis of lipodystrophy.


METHODS
Sixty HIV-infected patients were recruited from 1 June to 31 December 2006. A total of 34 patients were included in the lipodystrophy group and 26 in no lipodystrophy group. Thickness of subcutaneous fat was measured twice with a high-frequency (15 MHz) transducer by transverse scans at four skin-based reference points: the periumbilical region, the brachial region, the crural region and the malar region. Visceral fat thickness was determined with a low-frequency (3.75 MHz) transducer at two skin reference points: perirenal fat diameter and visceral abdominal fat.


RESULTS
Compared with HIV-infected patients without lipodystrophy, those with lipoatrophy or mixed lipodystrophy had thinner facial, arm and leg fat, whereas patients with lipodystrophy showed thicker intra-abdominal fat. The median of the ratio between intra-abdominal fat and subcutaneous fat and between perirenal fat diameter and body mass index in the lipodystrophy group was higher than in the no lipodystrophy group. The measurements of brachial, malar and crural fat were significantly lower in patients with lipodystrophy.


CONCLUSIONS
We consider the ratio between visceral adipose tissue and subcutaneous adipose tissue and the thickness of malar fat to be the most useful ultrasonographic parameters for the early diagnosis of lipodystrophy in HIV-infected patients on highly active antiretroviral therapy.
Grima
P F
PF
Operative Unit of Infectious Diseases, S. Caterina Novella's Hospital, Via Roma 1, 73013, Galatina, Lecce, Italy. pierfrancescogrima@yahoo.it
Chiavaroli
R
R
Grima
P
P
D050153:Abdominal Fat / Q000000981:diagnostic imaging; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D013997:Time Factors; D014463:Ultrasonography